University of Washington
Improving outcome of future transmission assessment surveys and community compliance for MDA in 14 LF endemic districts of Uttar Pradesh.
The success of MDA programs requires effective planning, community engagement, and delivery by community drug distributors. This proposal seeks to assess barriers and facilitators of effective coverage. Using in depth interviews, focus group discussions, and surveys, they will investigate factors related to acceptance, availability, and accessibility of MDA from the perspectives of drug distributors, healthcare workers, community leaders, the NTD program, and community members. Using the findings from the formative phase, an intervention package will be developed and implemented during MDA, followed by an evaluation of the impact of the intervention on coverage.
This project is part of a larger series of four studies that use a mixed methods approach to understand why particular districts that have undergone 5+ years of MDA are failing or are likely to fail transmission assessment surveys (TAS). Other studies include 169.1D Ghana, 169.2U Burkina Faso, and 177U Nepal. This study in Uttar Pradesh also provides a second opportunity to deploy the rapid ethnographic approach that will be first tested in Nepal. Team members from HERD Nepal will be traveling to India to train their team on the technique and assist with roll out.
Improving Mass Drug Administration After Pre-Transmission Assessment Survey (Pre-TAS) Failure: A Mixed Methods Study in Nepal
This study builds on the methods developed for the operational studies ongoing in Ghana and Burkina Faso. The first two research questions are the same as those earlier studies with two new questions added here- question 3 on triple drug therapy (ivermectin, DEC, albendazole – IDA) and 4 on the use of a new rapid ethnography approach.
- What factors are associated with effective (and lower) MDA coverage as defined as availability, accessibility, and acceptability in settings that have repeatedly failed Pre-TAS?
- What is the impact of an adapted and tailored intervention package on achieving effective coverage?
- What messages and community engagement approaches are needed to ensure the acceptability of IDA triple drug therapy in Nepal?
- How does the rapid ethnography approach compare to more traditional qualitative analysis methods in terms of cost, timeliness, and ability to provide required information for programmatic decisions? Can local capacity for use of this approach be built rapidly?
The DeWorm3 Project is a series of hybrid trials testing the feasibility of interrupting the transmission of soil transmitted helminths (STH), while conducting implementation science research that contextualizes clinical research findings and provides guidance on opportunities to optimize delivery of STH interventions.
The purpose of DeWorm3 implementation science studies is to ensure rapid and efficient translation of evidence into practice. Research methods include: (1) stakeholder mapping and network analysis, (2) qualitative research, (3) structural readiness surveys, (4) process mapping, and (5) economic evaluation (costing and cost-effectiveness).
Implementation science research aims include:
1)To systematically identify stakeholders influencing standard of care targeted and community-wide MDA and map their potential role and involvement in scale-up of community-wide MDA for STH.
2)To identify implementation-related barriers and facilitators to community-wide MDA for STH from the perspective of various stakeholders.
3)To quantify the readiness of the health system to deliver community-wide MDA for STH programs.
4)To map the intervention delivery process and identify any discrepancies between planned and implemented activities in order to optimize the trial intervention.
5)To compare the financial and economic costs and incremental cost-effectiveness of community-wide and targeted MDA for STH in the short- and long-term.